Objective To explore the efficacy of intense pulsed light in the treatment of melasma and its influence on satisfaction. Methods A total of 78 patients with melasma admitted to Jingjiang Chumu Medical Beauty Clinic from January 2023 to June 2024 were selected as the research subjects. They were divided into the control group and the experimental group by the random number table method, with 39 patients in each group. The control group received conventional western medicine treatment, and the experimental group received intense pulsed light treatment. The clinical efficacy, symptom improvement, quality of life, satisfaction and adverse reactions were compared between the two groups. Results The total effective rate in the experimental group was 94.87%, which was higher than 69.23% in the control group (P <0.05). After treatment, the scores of MASI, DLQI and MelasQOL in the experimental group were lower than those in the control group (P <0.05). The satisfaction in the experimental group was 97.44%, which was higher than 84.62% in the control group (P <0.05). The incidence of adverse reactions in the experimental group was 7.69%, which was lower than 41.03% in the control group (P <0.05). Conclusion Intense pulsed light treatment for melasma can effectively improve clinical symptoms, enhance the quality of life and patient satisfaction, and has high treatment safety, which is worthy of clinical application.